Getting up to speed

The Picard Maneuver@lemmy.world to ADHD memes@lemmy.dbzer0.com – 1010 points –
138

When starting these meds, Euphoria is a common side effect.

It can still make a huge difference in your life, but the euphoria isn't permanent.

I felt like the euphoria was from being able to focus and retain details about uninterrsting things for more tha a few minutes, and after a few weeks the novelty wore off.

That's why it's not prescribed willy nilly. If you can improve sustainably with coping mechanism, that's always healthier in the long term. It's always preferable to depend as least as possible on the meds.

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There's also usually a ramp up period with a lot of medication. It takes time before it really starts working so there's a very real chance this is more of a placebo effect

Not with stimulants, one of the major benefits of them is that they work immediately.

They also stop working quite suddenly.

I think it depends on the meds there to some extent. Anecdotal, and certainly not immune to my own placebo effects, but Adderall always feels pretty good at giving me laser eyes -- even when being a bit on/off with it.

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It's funny to think that previous generations were medicating themselves too without admitting it. 1930s-70s amphetamines are all the rage until it's declared an epidemic from the incredible amount of usage.

Then hard pivot to cocaine use to replace the amphetamines, which ends up not being better (and maybe destroying some countries in the process)

And now here we are back to amphetamine usage and far surpassing the levels of the epidemic of the late 60s-70s.

So remember if your grandparents say they never had to medicate themselves back in the day just ask them how much powder they sniffed up their noses. Apparently everyone feels good with a bit of stimulation.

And I feel like some people lean on energy drinks to fill a similar function as well.

Oh absolutely. Humans love stimulants.

It's funny to the degree that our society runs on being amped up by one drug or another.

Also wild when it doesn't work on you and you feel left out of some drugged up rave that everyone else seems to be participating in but I really don't want it.

Grandma had coke in her soda.

Great grandma did. They changed the formula before my grandmothers were born, and I know I'm older than a fair portion of you, being 43

man your bones must be turning into dust. shouldn't you be chatting with your friends at the retirement home by now instead of being on lemmy, grandpa? smh geezers

This but unironically

You unironically think 43 year old shouldn't be on Lemmy?

They don't mean the Coke recipe, their grandma put cocaine in her Sprite

It's never too late for the people that had parents that said "my kid isn't crazy" and grew up unmedicated and without support. I was a giant fuckup until 35 when I went and got a diagnosis and support. Graduated top of my class at 38, bought a house, got married, and now working on my masters degree.

Although... my meds have been on back order for the past two months...

I waited until the last minute to get a refill (work has been hell, and the entire having to call in for renewals is so anti ADHD it's not even funny) and was off them for the weekend and today, not even funny how much more anxious and cranky I am right now, I do not have any energy to deal with peoples stuff today.

The first 5-7 days off meds are the worst. It gets better after a little bit, but I'm pretty worthless for the entire time and definitely irritable. Ride it out, it'll get better!

Got lucky, got a partial refill, this week would have been so much worse...

How... do you go about getting diagnoses as an adult? I am 38 years old and relatively well adjusted, I think?. Career, home, family, degrees. But I always just thought I was just, idk, wierd, but I have learned to occasionally point my hyperfixation in a constructive direction. It is always fixated somewhere, getting through school, my job, but whatever I am fixated on, it is the only thing that matters in the whole world. I graduated at the top of my class with a 4.0 and all the awards and accolades possible. I am a high level supervisor at my work, etc. Like, I am doing OK, but other times I will get distracted, and for a month my fixation will be a video game, or my fish tank and my work will suffer. Once I lose interest I would rather put my head through a fucking wall than deal with the details of something I no longer care about. Even if other people depend on me to finish something it is pulling teeth for me to finish it. All it gets is a superficial level of attention. None of the passion. My life is a series of rabbit holes and half finished projects. For me I am fine, but the people around me that get neglected when I am on to something else.... if I am focused on my job, it consumes me, every waking second I am either at work, talking about work, working on stuff for work, getting another certification for work, and I am terrified if I try to refocus to try to maintain some sort of work life balance I will lose any reasonable interest in work and everything I have done will be for nothing.

Writing it out I feel far less "adjusted" than I thought... my wife has pointed it out for years how it actually affects me, (and her, and the kids) more than I realize. Sometimes I get in the threads in this sub and I have a "Oh, shit..." moment where I realize so many of my own patters relate to the comments in here and wonder what life would be like if I actually took care of it. I was diagnosed when I was like 7 but it was never followed through with or treated. IDK. 🤷‍♂️

My hobbies used to be collecting hobbies. CBT helped me realize that, and now I know when to pull back before I jump 10000% into a flavor of the month. I still get interested in things, but I give myself a 72-hour cooldown before purchasing anything new for a hobby. If I'm still interested after that, I dip my toes in. I more often than not realize it's just a fixation and save myself a ton of time and money that I can put towards my long-term goals.

If you feel you might have adhd you would want to start with getting a diagnosis. Usually, through a psychiatrist. From there, they can work on a treatment plan.

So can I start with something a little milder or do I need to jump straight in to CBT? I guess I was expecting to ease into things with maybe some light spanking or candle wax.

I finally asked my wife to find someone to discuss it with. Scheduling appointments is so difficult for me, let alone finding who I'm supposed to see, whether that's a vet, a doctor, or a mechanic. I imagine you can Google (or duckduckgo) "Adhd doctor near me" or something

Anyway, I only take meds on the days that I need to be productive, but same story. On those days it feels like I snuck a cheat sheet into a test. The same kind of "this is just how most people live? You can just get shit done?"

I basically talked to my regular doctor about it and he asked me a few questions before agreeing that I have ADHD and prescribing me meds. I didn't realize that was uncommon until I mentioned it too someone else though.

Although… my meds have been on back order for the past two months…

How does going off them affect you? I've always been hesitant to start medications for my issues because I worry what will happen if I lose my insurance or supply issues happen. It's getting to a point where I'm running out of coping strats that actually work though...

I have a stash because I tend to take on weekends or vacations unless I absolutely need it. I do this because I built up a tolerance at one point, and increasing the dose often left me gorked out.

For me, adderal just affects my focus, I don't have any ntocible mood issues that adderal improved. CBT was a bigger help for mood and impulsiveness.

What's gorked out mean?

Becoming one with the Speed Force. Excessive side effects of taking amphetamines. Taking chelated magnesium seems to help with leveling out the side effects.

Not OP, but for me I would feel very tired and unfocused (more so than usual) for a day or two, then I would be back to my baseline. There aren’t really any physical or emotional withdrawal effects for me.

I'm finally taking meds for my ADHD and while I don't feel like I can control what I focus on, it does seem to help in my ability to suppress distracting thoughts, especially when around others. I still have to put myself in situations where distractions are less likely to happen in order to get stuff done, but it does feel easier.

So like everything else, not a silver bullet but it does help. However I skipped a day and felt like shit; is withdrawal a thing?

I used to stay up half the night during college so I wouldn't get distracted. To this day, I kond of prefer being up late when nobody else is around bcz it means I won't get distracted easily.

What meds, instant/extended release, and what dosage?

I'm on Adderall XR 15mg and after an initial "holy fuck" phase for a couple weeks it's tapered off into a nice rhythm. Shit isn't perfect, but I'm able to get up and get shit done. However, I also have the "I'm not hungry because of Adderall thing. And the thought of eating right now disgusts me.". Which helps with the ADHD snack binges I've struggled with. So I'll take that over the upset/queasy stomach feeling I had with a non-stimulant med I took for a few months a couple years back

If I wind up skipping a day I'm usually fine and don't feel any negative impacts. However, I also drink a shit ton of coffee (typically black) so that could be helping curb any withdraw sysmtpoms.

is withdrawal a thing?

100%

Usually takes more than one day though. I skip weekends to prevent building a tolerance and don't get WD symptoms.

I've never felt withdrawal, but the old symptoms will return with a vengeance since you're not used to having them any more.

Well you are taking amphetamine. Of course you will have withdrawal.

They help but the side effects sometimes suck. Sweats/chills, lower blood pressure, etc. Worth it for the clarity I get though.

My problem now is that I’m burnt out, which no drug is going to fix.

Edit: it raises blood pressure and lowers your urination pressure. I mixed them up.

ADHD meds are lowering your blood pressure?

I forget what it's called but there is one medication that doesn't act as a stimulant and is closer to that of an antidepressant

Could be Bupropion or Atomoxetine. I've been on the former, but it didn't do a lot for my ADHD. It did give me a wonderful few weeks filled with panic attacks and having my mind convinced that every little ache I felt must be because I was dying of something. Of course everybody responds differently, so don't let that deter you if it is prescribed, but for me I never want to touch that stuff again.

I’m on Buproprion SR now for my recent ADHD diagnosis. That said, I absolutely know what you mean about the anxiety that it can give you! When I was younger, I was prescribed it for a different reason and it remains the only time in my life that I experienced actual panic attacks. I’m so relieved it hasn’t been my experience with it as an adult. I’m very fortunate to have a doctor that was taking my concerns serious and supportive as I adjusted to it - still is, we meet again in May. I’m not sure I’ll stay on it because it doesn’t do enough I feel like. Plus, while it doesn’t give me anything even close to panic attacks, it still makes me feel more anxious that usual I think…

I tried Atomoxetine and didn't like it, I don't recall any major mental benefits (maybe my motivation was non existent) but I did recall MAJOR sex related side effects that absolutely sucked.

Wow, that’s rough. I’m sorry you had to deal with that. I’ve been taking it for probably close to 8 months now give or take? No side effects like that but I’m still not entirely sold on it. It helps me focus, but I get sweats/chills from it, and it really fucks with my mood sometimes. I also don’t like how super hyperfocused I get sometimes while on it.

I have tried 4 or 5 meds for ADHD and nothing seems to work, or help at all :(

I've just been raw dogging it for my whole life

Let's see if Vyvanse is the magic bullet.

Concerta is at least making me do the dishes some times, unlike any of the other meds. Might help you.

I am on another form of Methylphenidate (Medikinet CR) and it has not been great.

Thought I heard that the side effects tend to be better with Concerta than the one I'm on.

Apparently the official Concerta version has some trademarked time-release technology, so it's a series of small evenly-spaced doses.
I don't know what about it is trademarked but it makes it very hard to compete with.

I'll have to ask my doc about Concerta then, it's supposed to be available here but apparently pharmacies have a hard time sourcing it :/

It definitely has the least side effects out of any of them for me, which is why I settled for it. It might work for you too.

Well there's your problem. You only need 1 medicine. If you eat more than they fight each other in your system and don't work because they die in battle. 4 or 5 is like a world War.

They likely tried them one after the other... Makes more sense before you assume they just down 4 different meds at the same time. Still possible of course.

I tried one after the other. Tried to give each of them a fair shot, using each for 30 or 60 days.

I ran out of Vyvanse three weeks back. It’s been months my rather low dose didn’t do its full effect anymore, I just didn’t go back to see my doc to get it adjusted. However, looking at how much of a disorganized mess I am these last couple of weeks, I guess it was still doing something - holy shit am I not getting much done, like, at all 😬

Yeah, I've felt a bit of the same. My meds don't seem to do much until I miss a dose then I'm like... Whelp, I'm fucking useless today.

At first the drugs have a kind of amplified effect, as that simmers down, the effects are still there, it's just, not as pronounced and noticable.

And to be clear to anyone who isn't ADHD and on meds, they're not magic. The ADHD is still definitely there, all the medication does is dim the effects to a more manageable level. Before medication, trying to get something done that my brain wasn't super interested in, would be like trying to nail jello to a wall. It just wouldn't happen. Now I can actually get myself off the couch, put down my phone and do a thing without feeling like I'm dragging my corpse along for the ride.

I used to be on ADHD stimulant meds up until I just tried living without them. Was on them as far back as I can remember, and then one day, I had no appetite, so I stopped and realized that the anxiety they gave me was hurting me more than I thought. Now, I'm on anxiety medication that sometimes makes it hard to focus, and I'm not entirely sure how to find that balance of being productive and not having panic attacks daily. Has anyone else experienced this?

Yes which is why I was switched over to the Strattera generic which isnt a stimulant. It helps but honestly therapy and exercise did most of the work.

Yes. Same experience. I have now dropped my Adderall to 2.5 to 5 mg per day, depending on how productive I need to be, splitting between 6 am for the first dose and noon or so for the second if I need it. I take 80mg of atomoxetine as well. Additionally on buspirone for anxiety and prazosin for PTSD symptoms I have from a childhood of undiagnosed ADHD. With that mix I find myself able to do things, capable of feeling some hunger, and not having panic attacks about the most meaningless garbage. But don't take my cocktail as gospel. Brains are weird. Everyone is different. Try everything until you find what balance works for you. If your doctor won't let you try and find the right meds and the right dose, get a different doctor.

Sounds similar to my girlfriend. She gets overwhelmed with how much she has to do that she freezes, then has a panic attack because nothing is getting accomplished. I help by picking whatever seems most pressing and telling her to focus on that and nothing else. When it's done we pick another thing.

I'm sure this isn't groundbreaking advice (or even good advice, "just do the thing" yeah no shit), but if you struggle with getting started it might be worth to ask someone to handle organizing the tasks for you.

That's kind of how I felt getting on some anti anxiety meds in my 40s. I have had "butterflies in my stomach" everyday since I was a kid, now they're pretty much gone.

I was 33 when I finally asked about a prescription; and I felt kinda dumb that I had been "just dealing with it" my whole life, when suddenly breathing had become much easier with ant-anxiety meds.

I guess I was worried about becoming addicted or would lose coping skills and become dependent on it in order to function. But nope. I was wasting so much mental energy before, just trying to wake up and feeling like the sun was screaming at me. I can taper down my dose when my anxiety is more controlled, sometimes I forget that I didn't take it. Sometimes I wake up and pretty much immediately take it.

It helped me to begin understanding my anxiety on a much different level than simply, "I'm just having a bad day". It was a game changer

I hear ya. I kind of just have always had a distrust of pharma generally and psych drugs specifically. What made me go for it ultimately was conversations with family members who had the same symptoms telling me how much it helped them. I was like damn, this shit is genetic, and maybe I don't just deserve it for not exercising or some shit.

I tried that. The meds bonked me out of my gourd so hard that a single dose had me trapped in a chair staring at a wall for an entire weekend. I ran away screaming and never looked back.

I'm on something pretty low dose and I take it before bed.

I gotta get back on the dose again. Lost insurance when I aged out of my folk's. Took closer to a decade to get a proper job & earn it back. Of course, now I've had proper job over a year -- yet to make a single appointment because, well, still raw-dogging reality without meds.

Tomorrow's a dayyy awayyyyy 🎶

ADHD is the worst at this.

A disorder that makes it hard to have cognitive function & execution has you required to do the following:

  1. Remember that you have the disorder.

  2. Remember that you can get treatment for it.

  3. Find a doctor/NP that specializes in ADHD or cognitive disorders.

  4. Schedule an appointment.

  5. Go to the appointment and go through the rigmarole of getting a new RX.

  6. (Current Market) Call around to pharmacies to find one that has your RX in stock and hope your medical insurance doesn't reject it or prescribe you something else because you don't have patient history with just Adderall yet and have to repeat this step because this pharmacy only had the other RX available.

  7. Go pick up your RX.

  8. Repeat 4-8 monthly since ADHD meds are tightly regulated and you can only get a 30-day supply without auto-refills.

Yeah.... We're completely setup for success.

It'll be fun if you try, hope you're not good at your job because then you're clearly just looking for drugs /s

Been off them since childhood since back then I never felt a difference between me taking them and not. Been considering trying them nowadays tho, you all reccon its worth a shot?

It's worth finding a doctor that treats adult ADHD and see the effect that meds have on you.

I somehow had untreated ADHD, but still managed to get good grades. It was amazing when I started taking meds for ADHD. There have been advances in some of the meds that help lessen the side effects. Also as an adult, you may be able to better perceive the difference between unmedicated and medicated states.

The biggest hassle is finding someone that treats adult ADHD and is on your insurance. Tons of people around me treat child ADHD, but there's only a handful of people around that treat adult ADHD.

I did fine through high school because it was easy enough. Studying was hard so I never learned how, just did a good job of winging most things without thinking them through, and being good at eliminating obvious wrong answers meant multiple choice tests were a breeze.

College was.a massive struggle because it required making my own schedule and studying, which I could not do. Ended up being diagnosed in my 30s and medication is so helpful that I am miserable whenever it gets on backorder. It did take trying a few different meds before finding the one that worked without negative side effects.

If you feel like you have a handle on remembering important things and have behaviors that keep your kife running smoothly then medication may not improve anything. But if you feel, or someone you trust feels that medication might help it would be worth seeing a doctor to discuss.

somehow had untreated ADHD

As if the whole diagnosed ADHD movement hasn't only just existed for the last 20-30 years. And really picked up steam with the increase in casual use of Adderall in the early 2000s

I talked myself out of meds in 7th-8th grade. My grades weren't great after that. I'm on atomoxetine now and it's got me pretty well focused. I feel much more productive when I'm on it.

I frequently talk myself in and out of them. I'm currently in an "out" period for the past couple of years. I miss the clarity, but not the side effects.

I had negative side effects from the first few I tried, only the ER version of generic ritalin had no side effects. The non-extended version made me jittery and wore off too fast and some of the other newer meds had some really bad side effects.

All of mine were tried as an adult, but I heard that some medications have different effects for the same people in their youth and adulthood or even just over time so changing the prescription might be an option if you go back to an "in" period.

I might. I've tried a few of the extended release versions, but the primary effects would only last the normal 4-6 hrs, and then I'd experience solely the negative side-effects for the rest of the day. I prefer the quick acting ones because I like it clearing my system faster, even if it's less convenient.

I was off meds from 13-35, and… I don’t personally find them to be worth the hassle at this point.

They work, sort of, they help, sort of, but the side effects are rough at a dose that works, a dose without side effects does nothing, and I’m so used to making myself function without them that it’s not really worth it to me. They don’t give me motivation they just help me execute tasks, which… means a lot of times when I take them I’m just that much more focused on nonsense.

I have a back-stock of about 6 months (I stopped getting them filled about a year ago) and just take them when I have a specific thing I need to do for a specific day. With that use they work great.

I’d say it’s worth a shot, but also worth having realistic expectations. It might be life changing for you, or you might have an experience more like mine. Still useful, but not really a crutch.

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Eli5. Isn't it just microdosing amphetamine?

Yeah, more or less. Stimulants tend to have a contradictory calming and/or focusing effect on the ADHD brain. I don’t remember why exactly but it probably has to do with dopamine regulation, which our brains crave like a zombie does brains.

My diagnosis kind of explained why I can drink inordinate amounts of coffee or energy drinks (don’t do this) and sleep like a log 30min later lol

Some brain cells make dopamine to reinforce behaviors. Dopamine slots into receptor, you get that feeling of satisfaction. A protein in the brain cell wall vacuums up excess dopamine so it doesn't just flood the brain forever, constantly triggering the receptors.
ADHD brain cell dopamine vacuums are just always on max speed all the time.
Methylphenidate slows the vacuums down so the dopamine doesn't get sucked right back down, meaning it actually has a chance to reach the receptors and do its job.

It's not quite that our brains crave dopamine, it's that our brains are too good at tidying it up, kinda like someone following around behind you as you set the table, putting all the clean dinnerware straight into the dishwasher unused.

my first dose of adhd meds was atomoxetine and instead of gaining clarity of mind all that happened was 56 hours of insomnia with gut wrenching nausea

It lasts about four days for me

And then what?

Then it’s back to normal, but it requires adderall to stay at the normal.

Hmm almost seems preferable to stay "normal" and try to come up with elaborate coping mechanisms.

Like I can't do a single thing at work without writing it down on a pad of paper. It's like my conscience and short and long term memory and fidget toy all wrapped in one.

I have done, though usually have to trick myself into it by doing something small and barely related so that a chain of activity gets started

I do this accidentally. I do one thing that's inhibited by another thing not being done, repeat, until I'm doing 3 separate tasks and forgot what I was trying to do initially until an hour later.

Thats how it works. By accident. Anytime i try to do something on purpose i lose interest real quick

I used to take meds growing up, but it caused me to completely lose my appetite and my BMI got really low. I had to stop because of that.

Damnit I forgot to take my meds this am, gonna be a rough day

Same when I got on ocd meds. Love being able to go and do a thing without compulsively making lists of every other tasks that I could be doing.

What's your drug name? If you don't mind me asking. Mine was risperidone but I had to stop.

To me, being on the meds makes me feel... weird? Slightly hollowed out? I can't find the best words for it, but the whole chorus of sensory input and thoughts and impulses that I'm used to off-meds somewhat quiets down and my head feels a lot emptier.

On the other hand, it has the significant advantage that there is more space for the things I do want to focus on, and I've figured out I can sort of fill the void with music. It creates a padding, further suppresses distractions, and I can filter it out quite well if I need to focus more intensely. It slightly depends on how well I know the music, but that's not a hard-and-fast rule either.

So I admit it's useful for being productive during the day and by extension good for my self-esteem and mental health if I know I can get stuff done, but I also enjoy when it wears off in the evenings and I sink back into the familiar bustle.

The side effects like heart rate, blood pressure, occasional feeling of anxiety and nervosity out of nowhere and increased sweating suck though. I could really do without them.

The down side is that you only get the meds if you can absorb being price-gouged for health insurance, at least here in the United States.

BUT, it's fun to see post's like OP's. Makes my heart go pitter patter.

Please notify your doctor if Adderall makes your heart go pitter patter for periods lasting longer than 2 hours.

I’m going to be doing this soon myself. Can this actually happen?

Be warned: not everybody gets this.

Myself, I've tried 5-6 different meds and have had nothing in the ways of the described. Might as well have been taking vitamins.

Just so you don't get too disappointed...

It's been 15+ years for me (although with lots of on and off), but if you're used to living with ADHD, it can feel like a fog is being lifted. You can suddenly hold more in your head at once and don't have to mentally "drop" a thought to be able to process other things. It's like slotting in an extra stick of RAM.

The meds probably have that effect on anyone, but it's profound if you've been working with a deficit.

I was diagnosed when I was 8. I’m now 52. I was taken off Ritalin because it made me “a zombie” according to my mother. Been untreated since.

Now I’m going in for reevaluation and testing again soon. Probably to be put back on meds. So I’ve definitely gotten used to living with it untreated.

This is probabaly largely due to the dosage.

Back in the 70s & 80s kids were, on-average, given 30mg instant release of Ritalin a day to start. These days they've cut that starting dose down to 5mg 2x a day for IR and the long acting is 10-20 once a day depending on the child's weight.

Dosage back then was also determined by severity of "undesired" symptoms instead of other factors like body mass and how well a lower starting dose is performing.

Yes, the first days are incredibly clear. After the first week it becomes less noticeable for most. Not that it's gone, just less present .

Sounds like concentration meditation.

(Aka samatha and a few others)

It'll give you the clarity and the amazing can-do power.

And unlike drugs, it has no ceiling. You can pump up that power to crazy heights.

Must be nice. The only one that works for me is Vyvanse which is literally just cocaine, and the max dose of 70mg causes my heart rate to hit 120 while sitting down and doing nothing but watching YouTube for two hours.

Why do you think it's cocaine?
It's just another amphetamine derivate

Because I’ve been told by my pharmacy tech wife and my doctor that it is. Or close enough, anyway.

EDIT: It turns out my ignorance of chemistry is enough to get me downvoted. In any case, thank you to the kind souls that have educated me on the matter.

Well, as a pharmacist whose been stable on 50mg of vyvanse for more than 3 years, your wife and Doc are both incorrect…

Both are stimulants, yes, but

Vyvanse is an amphetamine and works to produce more neurotransmitters you don’t already have.

Cocaine is a reuptake inhibitor… thus preventing the breakdown of neurotransmitters you do already have.

While fundamentally they may look like they’re doing the same thing, they are in fact 2 totally different mechanisms. Furthermore, in neurotransmitter depletion the effects of cocaine will severely diminish, where as amphetamines will thrive.

I think it's important to note that while chemicals can be similar in structure minor differences affect both their chemical properties and the way they interact with our body. Being close to something chemically has no bearing on what it does.

...tell them both to visit erowid or wikipedia, and look up cocaine and amphetamine separately. Then, look at vyvanse's wikipedia page. That type of description is part of the reason why it's tough for us ADHD folks to get access to our meds.

Definitely this.

Concerta is diet cocaine, whereas Vyvanse is a miracle (and Lisdex is the devil's apple)

My experience is the opposite. I used to take Adderall, and I fell that is too close to coke. I switched to Vyvanse about 6 months ago and I've been really liking it. It's much more soft, less of a comedown.

I take 60mg.

I’m really happy that it’s working well for you!

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It takes like 4-6 weeks to start seeing effects. She must have had "the placeebe effect"

Edit: I forgot Lemmy knows more about meds than doctors

Adderall IR hits in 20 mins and does not have the ramp up of other drugs.